Efficacy and Safety of Different Drug Regimens for Tuberculosis Preventive Treatment: A Systematic Review and Meta-Analysis

Shah, Rima; Khakhkhar, Tejas; Modi, Bhavesh

doi:10.7759/cureus.38182

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…Studies carried out worldwide found factors associated with TB preventive treatment adherence similar to those found in this study (treatment duration, immigrant contact), and factors different to those found in this study, such as absence of perception of risk, alcohol and drug use, and unemployment [ 11 , 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Several studies found that short-term TB preventive treatment regimens were associated with a greater treatment adherence than long-term treatments [ 14 , 24 , 25 , 26 , 27 ]. Nevertheless, other studies did not find significant differences for treatment adherence using different regimens [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, other studies did not find significant differences for treatment adherence using different regimens [ 20 ]. Currently, short-term TB preventive regimens are recommended based on their similar effectiveness compared with 6–9 months of isoniazid, favorable tolerability, and higher treatment adherence [ 6 , 7 , 8 , 11 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019−2021

Plans-Rubió,

Godoy,

Toledo

et al. 2024

TropicalMed

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The aim of this study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection for new cases of pulmonary TB cases reported in Catalonia in 2019–2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables; a p < 0.05 was considered statistically significant. Multiple logistic regression analysis was used to detect the independent factors associated with TB preventive treatment non-adherence; a p < 0.05 was considered statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: “exposure at school or workplace” (aOR = 3.34), “exposure to an index case without laboratory confirmation of TB” (aOR = 2.07), “immigrant contact” (aOR = 1.81), “male gender” (aOR = 1.75) and “exposure duration < 6 h per week or sporadic” (aOR = 1.60. By contrast, the factor “short-term TB preventive treatment regimen” (aOR = 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019−2021

Plans-Rubió,

Godoy,

Toledo

et al. 2024

TropicalMed

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“…Adverse event profile of 3HP is considered favourable compared to alternative regimens in previous studies [9,17]. The 3HP regimen is also considered superior to 9HP in terms of lower risk of hepatotoxicity [11].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is growing recognition of advancing the inclusion and expansion in coverage of TPT services as a key priority for TB elimination and achieving global end TB targets by interrupting the chain of TB transmission [6,8]. Newer TPT regimens, especially INH-Rifapentine (3HP) are effective short course regimens with improved safety profile which have potential for widespread utilisation in high-burden countries [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Implementation of tuberculosis preventive therapy with INH‐Rifapentine (3HP) for latent tuberculosis infection management in household tuberculosis contacts in India: A prospective study

Sharma,

Bakshi,

Basu

et al. 2023

Tropical Med Int Health

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ObjectiveThe primary objective of this study was to ascertain the acceptance, initiation, implementation and treatment completion rates of tuberculosis (TB) preventive therapy (TPT) using 3HP (INH‐Rifapentine) among household contacts of microbiologically confirmed drug sensitive TB cases on anti‐tubercular treatment under programmatic real‐world settings. The secondary objectives were to estimate the prevalence and predictors of latent TB infection (LTBI) in household contacts of the index TB cases. We also ascertained the safety profile of the 3HP TPT regimen in the household contacts.MethodsThis prospective observational study was conducted at 10 TB chest clinics in Delhi, India during 2022–2023. Household contacts aged 14 and older who tested positive for TB infection on a Tuberculin Skin test were initiated on the 3HP regimen. Logistic regression was performed by including statistically significant independent variables in multiple prediction models. p < 0.05 was considered statistically significant. STATA, version 15.1, was used to compute all analyses.ResultsA total of 1067 (84.68%) eligible contacts of microbiologically confirmed, drug sensitive TB cases underwent screening with tuberculin skin test (TST), 614 (95.6%) LTBI positive contacts accepted the initiation of TPT, and 564 (91.8%) of those initiated on TPT completed the treatment. The major reason for refusal of screening was the lack of perception of risk of TB disease due to asymptomatic status. The prevalence of LTBI positivity through TST was 61.5% (95% CI, 58.5%, 64.4%). Adverse events were reported by 195 (31.8%) contacts initiated on 3HP of which 20 participants discontinued TPT. None of the sociodemographic factors showed a significant association with LTBI positivity (except age) or TPT completion rates.ConclusionLTBI management with 3HP is feasible among adolescent and adult household contacts in India with high rates of adherence from initiation until treatment completion. The maximum attrition of participants occurred at the time of screening for LTBI using TST.

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Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers

Pamba,

Sanga,

Mlalama

et al. 2024

Preprint

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IntroductionTanzania rolled-out a 12-dose, weekly regimen of isoniazid plus rifapentine (3HP) TB preventive treatment in January, 2024. Although 3HP completion rate is generally ≥ 80%, variations exist depending on type of delivery strategy and programmatic setting. Prior to the roll-out, a mixed methods study was conducted to assess whether a family approach involving family member support, SMS reminders and three health education sessions, was acceptable and optimized 3HP uptake and completion. This paper describes acceptability of the family approach among people living with HIV (PLHIV), treatment supporters (TS) and community health workers (CHWs).MethodsThis was a qualitative descriptive study in 12 HIV care and treatment centers across six administrative regions. We purposively sampled 20 PLHIV, 12 CHWs for in-depth interviews and 23 TS for three focus group discussions held between September to December, 2023. The theoretical framework of acceptability guided thematic-content analysis using a framework approach.ResultsParticipants understood that PLHIV have high risk for active TB and that 3HP provides shortened treatment for TB disease prevention. They reported gaining TB and 3HP knowledge from health education sessions. However, participation of TS in health education sessions was low and many reported expensive transportation costs to clinics. Receiving support from someone close and SMS were perceived as good adherence reminders. The majority reported mild self-limiting side effects but expressed positive attitudes because of the shortened treatment, TB counselling, satisfaction from helping others, alignment with lifestyle and work responsibilities and reduced work burden. Some PLHIV reported difficulties in identifying family members for support thus, chose other close friends or CHWs.ConclusionsDelivery of 3HP with support from family members and SMS reminders is widely accepted by CHWs, PLHIVs and TS. Restricting support from only family members was unacceptable and attendance of all three health education sessions by TS may not be feasible.

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Efficacy and Safety of Different Drug Regimens for Tuberculosis Preventive Treatment: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 38 publications

Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019−2021

Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019−2021

Implementation of tuberculosis preventive therapy with INH‐Rifapentine (3HP) for latent tuberculosis infection management in household tuberculosis contacts in India: A prospective study

Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers

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